Print

Print


Dear Roger,


Thanks for your response and apologies, I was being lazy in using an acronym! I was indeed referring to "direct ion selective electrodes"/potentiometry. However, I wasn't suggesting that that method would provide a more accurate/true result, just that it is an alternative potassium method to those available on routine analysers that a number of labs have access to.


I agree that it would be useful to know the number of repeats that give different results and we are planning to audit this, my suspicion is that there will be none to speak of!


Best wishes,


Helen


Helen Jerina PhD

Senior Clinical Scientist

 

Department of Chemical Pathology

Level 4 Sandringham Building

Leicester Royal Infirmary

Leicester

LE1 5WW


From: Bertholf, Roger L., Ph.D. <[log in to unmask]>
Sent: 22 October 2018 13:35
To: JERINA, Helen (UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST); [log in to unmask]
Subject: RE: Potassium (again!)
 

Dear Helen:

 

Does “DISE” refer to direct potentiometry, such as one might have available on a whole blood analyzer? If so, I’m curious, what would lead you to suspect that direct potentiometry might produce a more accurate (lower) potassium in patients with no clinical suspicion of hyperkalemia? Hyperproteinemia or hyperlipidemia would produce falsely low potassium measurements using indirect potentiometry, and you would expect direct potentiometric measurement of electrolytes to produce higher results.

 

I’d also be interested in how often you obtain significantly different results on repeat measurement of potassium by the same method, but on another instrument.

 

Kind regards,

 

Roger

 

Roger L. Bertholf, PhD

Medical Director of Clinical Chemistry

Houston Methodist Hospital

Professor of Clinical Pathology and Laboratory Medicine

Weill Cornell Medicine

 

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JERINA, Helen (UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST)
Sent: Monday, October 22, 2018 7:07 AM
To: [log in to unmask]
Subject: Potassium (again!)

 

Hello Mailbase,

 

I know potassium is a favourite topic of conversation here, but I couldn't find anything substantial to answer my questions in the archives (although I would fully accept that that may be down to my inability to search them correctly!).

 

What I'd like to know is:

  • ​Do you re-run high potassiums and, if you do, is this by the same method or an alternative (e.g. re-check by DISE)?
  • What do you do with results where you suspect an artefactual cause? Do you take them out or do you report them with a comment?

Here in Leicester, our policy is to re-analyse all potassium results >6.0 mmol/L where there is no obvious explanation (e.g. poor renal function or haemolysis). As we don't have DISE available in the lab we re-run by the same method but on an alternative analyser. We report all results, adding a comment where appropriate and always ask for a repeat if artefactual increase is suspected. 


We are reviewing our policy and there has been some discussion as to whether repeating the analysis adds any value. It would be great to hear what other labs do and I'm happy to share/collate any responses.​

 

Best wishes,

 

Helen

 

Helen Jerina PhD

Senior Clinical Scientist

 

Department of Chemical Pathology

Level 4 Sandringham Building

Leicester Royal Infirmary

Leicester

LE1 5WW



********************************************************************************************************************

This message may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.

For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

Houston Methodist. Leading Medicine.

Houston Methodist is ranked by U.S. News & World Report as the No. 1 hospital in Texas for patient care. Houston Methodist is nationally ranked in 8 specialties and is designated as a Magnet hospital for excellence in nursing. Visit us at houstonmethodist.org. Follow us at twitter.com/MethodistHosp and facebook.com/HoustonMethodist.

***CONFIDENTIALITY NOTICE*** This e-mail is the property of Houston Methodist and/or its relevant affiliates and may contain restricted and privileged material for the sole use of the intended recipient(s). Any review, use, distribution or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please contact the sender and delete all copies of the message. Thank you.



********************************************************************************************************************

This message may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.

NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.

For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/